The Surveillance, Epidemiology, and End Results database is used to estimate the standardized incidence ratios (SlRs) of second primaries for all pairs of smoking-related cancers and to interpret the results in the context of our knowledge of the known effects of smoking on the incidence of each of the individual cancers.
The data reveal several clear patterns.
First, short-term incidence is uniformly much greater than long-term incidence.
Second, the SlRs are consistently much higher for women than for men, for every pair of cancers studied.
Third, the magnitudes of the SlRs are generally high and often substantially higher than would be expected on the basis of the known risks of smoking.
Exceptionally high SlRs are observed between kidney and bladder cancer and between head and neck and esophageal cancer.
Various nfluences may affect these high observed SlRs, including artifactual influences such as diagnostic, surveillance, and misclassification biases, and the effect of different exposure prevalences on subsequent SlRs, which may to some extent explain the strong sex differences.
However, these artifacts do not appear to explain the magnitude of the observed SlRs, especially the very strong associations between kidney and bladder cancer and between head and neck and esophageal cancer.
It seems likely that other factors play a role, including, possibly, host susceptibility factors or additional common risk factors other than smoking.
Although multiple primary cancers.
Mots-clés Pascal : Epidémiologie, Méthodologie, Tumeur maligne, Incidence, Association, Homme, Toxicité
Mots-clés Pascal anglais : Epidemiology, Methodology, Malignant tumor, Incidence, Association, Human, Toxicity
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 95-0508624
Code Inist : 002B30A01A1. Création : 01/03/1996.